Sports And Recreation
Survey

2. List one sport or physical activity in which
you participate or have participated:

3. How long have you participated in this?

4. How did you get started?

5. Describe any special adaptations you use:

6. Have you competed in any events, won events,
won trophies /awards, etc? Describe:

7. What advice would you give to other blind kids
about this sport/activity?

[ ] Yes, you may give my name, address, and phone
number to other parents who would like to contact me for more
information.

[ ] No, you may NOT give my name, address, and
phone number to others. Information from this survey may be used
only for articles and other public information purposes. I understand that our names and
the state we live in may be used for this purpose.